Under a different presidential regime – one that respects the separation-of-powers and the rule of law – holding Florida’s Medicaid matching funds hostage would not be an issue after the Supreme Court ruled 7-2 that ObamaCare cannot compel states unwilling to expand their Medicaid program.

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Was the U.S. Supreme Court serious when it upheld ObamaCare, but said the federal government couldn’t “hold a gun to the head” of states that choose not to expand Medicaid?

A new lawsuit initiated by Florida and supported by Texas may provide an answer.

Florida Governor Rick Scott, a Republican, is embroiled in a bitter fight with the Obama White House over whether federal Medicaid funds can be conditioned on a state’s expansion of the program under ObamaCare.

At issue is a threat by the Obama administration to withhold more than $1 billion in federal payments to Florida hospitals if Scott refuses to expand the population eligible for Medicaid.

“It is appalling that President Barack Obama would cut off federal health care dollars to Florida in an effort to force our state further into ObamaCare,” Scott said last week. He has since directed the state’s Attorney General to file a lawsuit challenging the linkage of federal funding to Medicaid expansion.

Scott’s announcement drew a swift rebuke from White House press secretary Josh Earnest. “It’s difficult to explain why somebody would think that their political situation and their political interest is somehow more important than the livelihoods of 800,000 people,” he said.

But Florida isn’t alone in pushing back against constitutional overreach.

“When the federal government exceeds its constitutional authority, the States must take action,” Texas Governor Greg Abbott, also a Republican, said in a statement. “[I] commend Governor Rick Scott’s decision to take legal action to protect these important constitutional principles.”

The principles at stake are whether the federal government can force states to participate in spending programs against their will, and whether the executive branch can ignore a clear command by the U.S. Supreme Court that it cannot.

Under a different presidential regime – one that respects the separation-of-powers and the rule of law – holding Florida’s Medicaid matching funds hostage would not be an issue after the Supreme Court ruled 7-2 that ObamaCare cannot compel states unwilling to expand their Medicaid program. In NFIB v. Sebelius (2012), Chief Justice John Roberts made clear that states have full discretion to accept or reject ObamaCare’s expansion offer, at no risk financially if they decline.

Unlike previous alterations, ObamaCare’s “Medicaid expansion… accomplishes a shift in kind, not merely degree,” wrote Roberts. “The original program was designed to cover medical services for four particular categories of the needy: the disabled, the blind, the elderly, and needy families with dependent children. Previous amendments to Medicaid eligibility merely altered and expanded the boundaries of these categories. Under [ObamaCare], Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level. It is no longer a program to care for the neediest among us, but rather an element of a comprehensive national plan to provide universal health insurance coverage.”

Moreover, ObamaCare originally gave the Secretary of Health and Human Services the power to strip states of all federal matching dollars if states refused to expand Medicaid eligibility.

With this in mind, the Court held that the law’s take-it-or-lose-it rules on Medicaid expansion unconstitutionally coerce states into spending money they otherwise would not. “The threatened loss of over 10 percent of a State’s overall budget… is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion,” wrote Roberts. 

Less than three years later, the Obama administration is attempting to engage in exactly the same kind of “economic dragooning” the Supreme Court forbade. Federal Medicaid funding for Florida’s hospitals runs out on June 30, and Obama administration officials are insisting that the state expand its Medicaid population or lose more than $1 billion.

It’s a shame that Florida must once again go through a lengthy court battle to get the equivalent of a restraining order against an out-of-control executive branch, but such is the case. In the meantime, expect the Obama administration to continue its run as one of the most lawless in our nation’s history.